Individual
MELISSA YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 957-8076
Mailing address
6415 MAPLE DR, MISSION, KS 66202-4317
(913) 957-8076
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01399
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200673850A
—
KS
Enumeration date
08/16/2010
Last updated
04/09/2015
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